Numerous designs of medical endoscopic devices are already known, for example from documents DE 3928532, DE 19918961, EP 1 726 254 and DE 2504663.
In order to limit the effort required by the operator and make the use of the endoscope and it instruments easier, simpler and safer, particularly during precise interventions that take a long time, it has been proposed to motorise at least some of the manoeuvres and actions, in particular those associated with the bending of the ends of instruments and the operation of tools.
Earlier motorised designs of this kind are known in particular from documents DE 2504663, EP 0 078 017, DE 4213418, as well as from the following publications:
“Design of a Telemanipulated System for Transluminal Surgery”, B. Bardou et al.: IEEE Engineering in Medicine and Biology Conference (EMBC 2009), Minneapolis, Minn., United States, September 2009;
“Control of a multiple sections flexible endoscopic system”, B. Bardou et al.: International Conference on Intelligent Robots and Systems (IROS), Taipei, Taiwan, pp. 2345-2350, October 2010;
“Design of a robotized flexible endoscope for natural orifice transluminal endoscopic surgery”, B. Bardou et al.: Computational Surgery and Dual Training”, M. Garbey et al (Eds.), chapter 9, pp. 155-170, Springer, ISBN: 978-1-4419-1122-3, 2010.
An additional step in the motorisation and increase of comfort and effective use of such endoscopes has been achieved by the embodiment described in document WO-A-2013/132194, as well as in document: “Introducing STRAS: A New Flexible Robotic System for Minimally Invasive Surgery”; A. De Donno, L. Zorn, P. Zanne, F. Nageotte, M. de Mathelin; IEEE International Conference on Robotics and Automation (ICRA 2013), Karlsruhe, Germany, May 2013.
However, despite the assistance provided by this generalised motorisation of the endoscope and its instruments, the aforementioned known systems do not meet the expectations of operators (generally surgeons) in an optimal manner, because of the lack of user-friendliness and ergonomics of the currently available handling interfaces which lead to fatigue and stiffness after prolonged use. Said known interfaces usually only provide a limited, or even non-existent, intuitive use, and because of this require a long and tedious training period.
Furthermore, the structures of the existing interfaces are generally relatively complex and fragile.
These disadvantages, as well as the presence of control elements that are often ill-adapted to the control of the instruments, have been verified in particular by the authors of document: “Master/Slave Control of Flexible Instruments for Minimally Invasive Surgery”; Antonio De Donno, Florent Nageotte, Philippe Zanne, Lucile Zorn, Michel De Mathelin; IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS 2013).
Finally, US 2003/0109957 discloses a microwrist system with a master interface device for remotely controlling at least one medical instrument for investigation or surgical intervention, wherein said or each instrument has several motorised degrees of freedom, and among them an ability to perform a translation movement relative to a canula, an ability to rotate around itself and an ability to bend the operational distal end of the instrument supporting the tool or similar effector.
This known master interface device is able to deliver signals for actuating units controlling the three degrees of freedom of the instrument or each instrument concerned and said master interface device comprises two control handle devices and a display screen of a video image of the intervention or investigation site provided by the system.
Each control handle device consists of a sub-assembly able to be manipulated with the same degrees of freedom as the associated controlled instrument and comprising a gripping and manoeuvring handle shaft, designed to be gripped with the whole hand by the operator, and a mounting bracket supporting said shaft.
Each handle shaft is pivotally mounted on the corresponding bracket, its physical axis being identical with its pivoting axis.
Said brackets are themselves pivotally mounted on bar structures extending laterally on both sides along the operator's forearms and chair. Said bar structures are linked to a support structure located behind the operator's back via successive elbow and shoulder joints.
Thus, the system according to US 2003/0109957 is quite cumbersome and complex, extends all around the operator and is not satisfactory in terms of intuitiveness and user comfort.